Maternity - Resuscitation Of The Newborn Infant

4m ago
19 Views
0 Downloads
852.45 KB
13 Pages
Transcription

GuidelineMaternity - Resuscitation of the Newborn InfantSummary This Guideline aims to optimise, facilitate and standardise newborn resuscitation byendorsing the Australian and New Zealand Committee on Resuscitation (ANZCOR)Guidelines - Section 13: Neonatal Guidelines (2016- 17)1 for use in NSW. TheGuideline outlines the mandatory education and training requirement and theresources available to support this.Document type GuidelineDocument number GL2018 016Publication date 15 June 2018Author branch Clinical Excellence CommissionBranch contact (02) 9269 5500Review date 15 June 2023Policy manual Patient Matters Manual for Public Health OrganisationsFile number 16/2551Status ActiveFunctional group Clinical/Patient Services - Baby and Child, MaternityApplies to Local Health Districts, Public Hospitals, Specialty Network Governed Statutory HealthCorporationsDistributed to Divisions of General Practice, Government Medical Officers, Ministry of Health, NSWAmbulance Service, Private Hospitals and Day Procedure Centres, Public HealthSystem, Tertiary Education InstitutesAudience Clinicians who care for newborn infants in NSW Health maternity and relatedenvironmentsSecretary, NSW Health

GUIDELINE SUMMARYMATERNITY – RESUSCITATION OF THE NEWBORN INFANTPURPOSEThis Guideline aims to optimise, facilitate and standardise newborn resuscitation byendorsing the Australian and New Zealand Committee on Resuscitation (ANZCOR)Guidelines - Section 13: Neonatal Guidelines (2016- 17)1 for use by NSW Health.KEY PRINCIPLESThis Guideline applies to all clinicians who care for newborn infants in maternity andrelated environments and to the resuscitation of the newborn immediately following birthand during the birth admission.USE OF THE GUIDELINEThis Guideline: replaces the Policy Directive PD2008 027 Maternity - Clinical Care andResuscitation of the Newborn Infant endorses ANZCOR Guidelines (2016-2017) Section 13 - Neonatal guidelines13.1-13.10 and the Newborn Life Support algorithm (Attachment 1) outlines local health district responsibilities to develop systems to ensure:oclinicians are appropriately targeted to complete mandatory andrecommended newborn basic life support education, training and proficiencyrequirementsolocally determined clinicians complete newborn advanced life supporteducation, training and proficiency requirements, and are in attendance atthe birth of newborn infants who are at higher risk of requiring resuscitation atbirthostandardised newborn resuscitation equipment is available and operationaland clinicians are familiar with the equipmentolocal procedures are in place to review resuscitation interventions andoutcomes to monitor patient safety and quality of care and improve trainingand performance.REVISION HISTORYVersionJune 2018(GL2018 016)Approved byDeputy Secretary –Strategy andResourcesAmendment notesGuideline replaces PD2008 027 Maternity – Clinical Care andResuscitation of the Newborn InfantUpdated advice from Australian and New Zealand Committeeon ResuscitationMandatory newborn resuscitation education and trainingMay 2008(PD2008 027)January 2005Director GeneralReplaces PD2005 242 Children- Clinical care/Resuscitation/Newly Born infant – AHS Development of Policy/ProceduresReplaces Framework for Area Health services to developGL2018 016Director GeneralIssue date: June-2018Page 1 of 2

GUIDELINE SUMMARY(PD2005 242)February 2002Circular No2002/30Acting Director Generalpolicy and procedures related to clinical care and resuscitationof newly born infant.NewATTACHMENTS1. Maternity – Resuscitation of the Newborn Infant: GuidelineGL2018 016Issue date: June-2018Page 2 of 2

Maternity - Resuscitation of the Newborn InfantGUIDELINEIssue date: June-2018GL2018 016

Maternity - Resuscitation of the Newborn InfantGUIDELINECONTENTS1BACKGROUND . 11.1 Purpose . 11.2 Scope . 11.3 About this document . 11.4 Key definitions. 11.5 Relevant NSW Health Policy Directives and Guidelines . 22LOCAL HEALTH DISTRICT RESPONSIBILITIES . 23EDUCATION FOR HEALTH PROFESSIONALS . 23.1 Newborn Basic Life Support . 23.2 Newborn Advanced Life Support . 34RESOURCES . 35DOCUMENTATION . 35.1 Newborn Resuscitation Record . 35.2 Resuscitation plans . 36CARE OF THE FAMILY . 37REFERENCES. 48LIST OF ATTACHMENTS . 4GL2018 016Issue date: June-2018Contents page

Maternity - Resuscitation of the Newborn InfantGUIDELINE1BACKGROUNDThe transition from fetal to extra-uterine life occurs through a series of uniquephysiological events. Newborn resuscitation therefore requires a graded response forthose newborns who are not making this transition effectively.The need for newborn resuscitation may be anticipated, but there are many occasionswhen it is unexpected. While approximately 85 percent of births require no intervention toinitiate spontaneous breaths, approximately 10 percent of newborns will need minimalinterventions, a further 3 percent will require positive pressure respiratory support andanother 2 percent will need to be intubated to support respiratory efforts. The full range ofresuscitation interventions will be required by 0.1 percent of newborns.11.1 PurposeThis Guideline aims to optimise, facilitate and standardise newborn resuscitation byendorsing the Australian and New Zealand Committee on Resuscitation (ANZCOR)Guidelines - Section 13: Neonatal Guidelines (2016- 17)1 for use by NSW Health.1.2 ScopeThis Guideline applies to all clinicians who care for newborn infants in NSW Healthmaternity and related environments.For the purpose of this Guideline the term ‘newborn resuscitation’ applies to theresuscitation of the newborn infant immediately following birth and during the birthadmission.1.3 About this documentThis Guideline replaces PD2008 027 Maternity - Clinical Care and Resuscitation of theNewborn Infant and endorses ANZCOR Guidelines (2016-2017) Section 13 - NeonatalGuidelines 13.1-13.10 for use by NSW Health clinicians.The ANZCOR Neonatal Guidelines for resuscitation are drawn from consensus treatmentand resuscitation recommendations from: International Liaison Committee on Resuscitation (ILCOR),2 which includesrepresentation from the Australian Resuscitation Council (ARC) and the NewZealand Resuscitation Council (NZRC). American Heart Association Guidelines for Cardiopulmonary Resuscitation andEmergency Cardiovascular Care (Neonatal) 2015. 3 European Resuscitation Council Guidelines for Resuscitation 2015.41.4 Key definitionsBirth admission - initial hospital stay following birthMandatory training - training that an employee or contractor of NSW Health mustcompleteGL2018 016Issue date: June-2018Page 1 of 8

Maternity - Resuscitation of the Newborn InfantGUIDELINE1.5 Relevant NSW Health Policy Directives and GuidelinesThis Guideline should be read in conjunction with:PD2012 069 Health Care Records – Documentation and ManagementPD2013 049 Recognition and Management of Patients who are Clinically DeterioratingPD2014 030 Using Resuscitation Plans in End of Life DecisionsGL2016 018 NSW Maternity and Neonatal Service Capability Framework2LOCAL HEALTH DISTRICT RESPONSIBILITIESThe Chief Executives of local health districts (districts) are responsible to ensure: all clinicians targeted for mandatory newborn basic life support (NBLS) attendeducation and training and are assessed as proficient5 a clinician who has completed additional education and training, and assessed asproficient in newborn advanced life support (NALS), is available to attend birthswhere there is increased likelihood of the newborn infant requiring resuscitation1,6 standardised resuscitation equipment should be available in NSW Healthenvironments where newborn care is provided (Attachment 2). A system shouldbe in place to ensure clinicians are familiar with the equipment and it is operationalat all times1,6 processes are in place to guide escalation and transfer of care in line withPD2013 049 Recognition and Management of Patients who are ClinicallyDeteriorating and GL2016 018 NSW Maternity and Neonatal Service CapabilityFramework local procedures are in place to review resuscitation interventions and outcomes tomonitor patient safety and quality of care and improve training and performance.3EDUCATION FOR HEALTH PROFESSIONALS3.1 Newborn Basic Life SupportNBLS education and training is mandatory for all NSW Health maternity clinicianscurrently targeted for Fetal welfare assessment, Obstetric emergencies and Neonatalresuscitation Training (FONT).The training is also recommended for clinicians who provide newborn care in shared andrelated environments (e.g. newborn nurseries) and clinicians who may attend birthswhich occur outside the birth suite. These clinicians should be locally determined.NBLS training, education and assessment for NSW Health clinicians consists of: online training to be completed every 5 years andGL2018 016Issue date: June-2018Page 2 of 8

Maternity - Resuscitation of the Newborn InfantGUIDELINE practical component - Newborn Basic Life Support Practical Session - to becompleted annually.3.2 Newborn Advanced Life SupportEducation and training in NALS, in addition to NBLS, is available via My Health Learningfor those NSW Health clinicians who may be called upon to attend births where there isincreased likelihood of the newborn requiring resuscitation.1 The training needs of theseclinicians should be locally determined.Simulation training, where available, may enhance clinical performance.1,7,84RESOURCESTo support standardisation of newborn resuscitation, the following resources areprovided and should be available to clinicians:5 the ANZCOR Newborn Life Support algorithm defines a sequence of simultaneousevaluation and resuscitation interventions (Attachment 1)1 a list of recommended equipment for resuscitation that should be available inNSW Health environments where newborn care is provided (Attachment 2).1,6DOCUMENTATION5.1 Newborn Resuscitation RecordDocumentation of newborn resuscitation interventions and response to treatment mustoccur during the event. The NSW Health Newborn Resuscitation Record has beendesigned to support and standardise this documentation. The record should be used atevery newborn resuscitation event to monitor patient safety and quality of care.5.2 Resuscitation plansResuscitation plans can be made, in line with PD2014 030 Using Resuscitation Plans inEnd of Life Decisions. The content and outcome of these discussions should bedocumented in the patient clinical record and a system should be in place to ensurerelevant clinicians are aware of these plans.6CARE OF THE FAMILYParticular consideration should be given to the communication that takes place withparents/ families whilst newborn resuscitation is occurring, and following the event.Regardless of the outcome of the resuscitation, some parents/ families may needadditional support.1 Clinicians should be sensitive to their needs and take into accountGL2018 016Issue date: June-2018Page 3 of 8

Maternity - Resuscitation of the Newborn InfantGUIDELINEcultural considerations for the family, and refer appropriately when required. Supportservices may include:7 Aboriginal support services - midwives, health workers and liaison officers multicultural health services for specific cultural groups.REFERENCES1.Australian and New Zealand Council of Resuscitation (ANZCOR) Neonatal Guidelines:Section 13. 2016 - 17 https:/resus.org.au2.Wyllie J, Perlman JM, Kattwinkel J, et al. Part 7: Neonatal resuscitation: 2015International Consensus on Cardiopulmonary Resuscitation and EmergencyCardiovascular Care Science with Treatment Recommendations. Resuscitation. 2015;95:e169-201.3.Wyckoff MH, Aziz K, Escobedo MB, et al. Part 13: Neonatal Resuscitation: 2015American Heart Association Guidelines Update for Cardiopulmonary Resuscitation andEmergency Cardiovascular Care. Circulation 2015; 132:S543-60.4.Wyllie J, Bruinenberg J, Roehr CC, Rudiger M, Trevisanuto D, Urlesberger B. EuropeanResuscitation Council Guidelines for Resuscitation 2015: Section 7. Resuscitation andsupport of transition of babies at birth. Resuscitation 2015; 95:249-63.5.Australian Commission on Safety and Quality in Health Care, National Safety and QualityHealth Service Standards (September 2012). Sydney. ACSQHC, Standard: 9Recognising and Responding to Clinical Deteriorat